Effectiveness of “Reducing Disability in Alzheimer’s Disease” Among Dyads With Moderate Dementia

Replications of evidence-based dementia care receiver–caregiver dyad interventions in the community are scarce. We aimed to assess the effectiveness of the Kansas City implementation of Reducing Disability in Alzheimer’s Disease (RDAD) among a convenience sample of dyads with moderate dementia, which addressed needs identified by nine participating community agencies. We hypothesized that dyads’ mental health and physical activity outcomes would improve from baseline to end-of-treatment. The final analytic sample included 66 dyads. Outcomes improved (p < .01) from pre- to post-intervention: behavioral symptom severity (range 0–36) decreased from 11.3 to 8.6, physical activity increased from 125.0 to 190.0 min/week, caregiver unmet needs (range 0–34) decreased from 10.6 to 5.6, caregiver behavioral symptom distress (0–60) decreased from 15.5 to 10.4, and caregiver strain (0–26) decreased from 11.1 to 9.7. This adapted implementation of RDAD leads to clinically meaningful improvements and might inform scaling-up.

[1]  Carolyn M. Rouse.  Evidence of What , 2018 .

[2]  P. Massman,et al.  Cognitive and Functional Correlates of NPI-Q Scores and Symptom Clusters in Mildly Demented Alzheimer Patients , 2016, Alzheimer disease and associated disorders.

[3]  Alzheimer’s Association,et al.  2016 Alzheimer's disease facts and figures , 2016, Alzheimer's & Dementia.

[4]  A. Schuchat.  DEPARTMENT OF HEALTH & HUMAN SERVICES , 2015 .

[5]  J. Cummings,et al.  Values of the Minimal Clinically Important Difference for the Neuropsychiatric Inventory Questionnaire in Individuals with Dementia , 2015, Journal of the American Geriatrics Society.

[6]  Alison Bowes,et al.  Evidence of what works to support and sustain care at home for people with dementia: a literature review with a systematic approach , 2015, BMC Geriatrics.

[7]  L. Gitlin,et al.  Translating Evidence-Based Dementia Caregiving Interventions into Practice: State-of-the-Science and Next Steps. , 2015, The Gerontologist.

[8]  Alzheimer’s Association.  2015 Alzheimer's disease facts and figures , 2015, Alzheimer's & Dementia.

[9]  L. Teri,et al.  Statewide Implementation of “Reducing Disability in Alzheimer’s Disease”: Impact on Family Caregiver Outcomes , 2014, Journal of gerontological social work.

[10]  J. Rey-Lopez,et al.  Sedentary Behavior and Health Outcomes: An Overview of Systematic Reviews , 2014, PloS one.

[11]  K. Buckwalter,et al.  Anxiety and stigma in dementia: a threat to aging in place. , 2014, The Nursing clinics of North America.

[12]  B. Cuthbert,et al.  Reenvisioning Clinical Science , 2014, Clinical psychological science : a journal of the Association for Psychological Science.

[13]  C. Lyketsos,et al.  Nonpharmacologic management of behavioral symptoms in dementia. , 2012, JAMA.

[14]  J. Gaugler,et al.  The problem with “problem behaviors”: a systematic review of the association between individual patient behavioral and psychological symptoms and caregiver depression and burden within the dementia patient–caregiver dyad , 2012, International Psychogeriatrics.

[15]  Wendy Moyle,et al.  Dementia and loneliness: an Australian perspective. , 2011, Journal of clinical nursing.

[16]  J. Schimmel,et al.  Aging in Place: Do Older Americans Act Title III Services Reach Those Most Likely to Enter Nursing Homes? Washington, DC: Mathematica Policy Research , 2010 .

[17]  K. Langa,et al.  Prevalence of Neuropsychiatric Symptoms and Their Association with Functional Limitations in Older Adults in the United States: The Aging, Demographics, and Memory Study , 2010, Journal of the American Geriatrics Society.

[18]  Patrick Z Pearce,et al.  Exercise is Medicine™ , 2008, Current sports medicine reports.

[19]  E. Clipp,et al.  Caregivers' reasons for nursing home placement: clues for improving discussions with families prior to the transition. , 2006, The Gerontologist.

[20]  F. Schmitt,et al.  The emotional ramifications of unmet need in dementia caregiving , 2004, American journal of Alzheimer's disease and other dementias.

[21]  A. LaCroix,et al.  Exercise plus behavioral management in patients with Alzheimer disease: a randomized controlled trial. , 2003, JAMA.

[22]  S. Travis,et al.  Analysis of the reliability of the modified caregiver strain index. , 2003, The journals of gerontology. Series B, Psychological sciences and social sciences.

[23]  J. Cummings,et al.  Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. , 2000, The Journal of neuropsychiatry and clinical neurosciences.

[24]  D. Rubio,et al.  Assessing the validity and reliability of well-being and stress in family caregivers , 1999 .

[25]  A. LaCroix,et al.  Exercise and activity level in Alzheimer's disease: a potential treatment focus. , 1998, Journal of rehabilitation research and development.

[26]  B. Reisberg,et al.  The Global Deterioration Scale for assessment of primary degenerative dementia. , 1982, The American journal of psychiatry.

[27]  A. Ojagbemi,et al.  Exercise and Quality of Life in Dementia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials , 2019, Journal of applied gerontology : the official journal of the Southern Gerontological Society.